| Street | Industrial Rd | ||
| City/Town | Emporia | ||
| State/Province/Region | Kansas | ||
| Zip/Postal Code | 66801 | ||
| Phone Number | (620) 343-3206 | ||
| Country | United States |
| Full Name | Miss Elna Lehner DDS | ||
| Gender | female | ||
| Birthday | 1973-11-16 | ||
| Social Security Number | 415-99-0039 |
| Credit card brand | Discover | ||
| Credit card number | 6011830014270510 | ||
| Expire | 2027/11 | ||
| CVV | 063 |